By Roz Rogoff
Part 3: Going HomeUploaded: Feb 7, 2013
I was discharged from the hospital on January 25th. Dr. M. Michael Kazemi stopped in my room to tell me I could go home Friday evening or stay overnight and leave Saturday morning. Even though I wanted to go home, I thought it would be better to stay another night. I called my neighbors and told them I would be ready to leave by mid-morning.
My neighbors came to pick me up around 10:30 Saturday morning. I was dressed in one of the outfits my other neighbor brought from home and I thought I was ready to go. Vilma, my CNA (Certified Nursing Assistant) came in to check my vitals. She was concerned about my oxygen level, which was 88%. She said it had to be 92% for me to go home.
My nurse, Brenda, came in and did the tests again and my oxygen levels were still too low. She was also concerned about my breathing because broken ribs make it painful to take deep breaths. She said I would need to keep my lungs clear after I got home to keep from getting pneumonia.
I was given a "Voldyne 5000" machine to strengthen my breathing. The Doctor said I should use it ten times each hour during the day. The nurse said it should be my best friend. I tried using it but the volume indicators didn't move much.
Two guys from Respiratory Therapy came up to give me more tests. They walked me around the halls, chatting about my cats to keep me from thinking about my breathing, and took a new test every minute or so. Some were up and some were down, so they hooked me up to an oxygen tank and tried again. This worked better, so I could be discharged as long as I had oxygen at home.
Dr. Kazemi arranged for the oxygen from Apria Healthcare and my nurse, Brenda, called in the prescription for my pain medication to the Custom Care Pharmacy in the Market Place. Brenda tried to arrange for a Home Health nurse to come out to my house to check on me after leaving the hospital. Brenda said she was having trouble finding someone to come to San Ramon.
I changed my Medicare Supplemental Insurance from AARP's United Health Care to a Humana HMO for 2013. What I didn't know, and it wasn't made clear when I enrolled, is that Humana is connected to the John Muir Medical Group and I was limited to using Doctors and services in this group. John Muir is a fine medical group, but as one of the nurses said, it isn't well-represented in San Ramon yet.
I read an article that John Muir is investing in San Ramon Valley Regional Medical Center. Once that goes through there should be a wider selection of providers, but right now it isn't as easy to find someone here from John Muir.
I learned this in January when I wanted to have a chalazion (lump on my eyelid) removed. Even though the Humana website listed many Ophthalmologists in San Ramon, my Primary Care Physician was only able to find two covered by my plan. One has an office in San Ramon but only his Walnut Creek office was approved, but he wasn't taking patients for six weeks. The other was in Pittsburgh. So I decided to continue using hot compresses on my eyes until the lump goes away.
At least this isn't anything serious, but I was shocked to find that my choice of Specialist is much more limited in the John Muir plan than the old AARP plan. I suspect this was one of the reasons it took so long to arrange for the home nursing care.
The nurse and physical therapist that came last week are excellent, but I felt confused and abandoned that first week out of the hospital. I was still shaken up from the accident and the pain. Thankfully my neighbor filled in with as much help as she could short of medical tests.
The Custom Care Pharmacy closes at 4 pm on Saturday, so by the time I was ready to leave it was closed. Brenda phoned in another prescription to the 24 hr. CVS on San Ramon Valley Blvd. The oxygen guy from Apria came with an oxygen tank for me to take home. He said he would follow us home to hook up the complete system. Since we had to pick up the medicine at CVS, we would not be going directly to my house. He said he would take a break and meet me there at 6:30 pm.
So I packed up everything and got into my neighbor's car. It wasn't as painful as I thought it would be. My other neighbor sat in the back and went into the CVS to pick up the medication.
We got home just about 6 pm and the man from Apria came at exactly 6:30 pm. He set up the oxygen equipment and showed me how to use it. I was finally back to normal, or at least on my way back to normal.
It's hard to believe that accident was only two weeks ago. Time seemed to drag that first week. Every day seemed like two days. I would sleep for two hours and wake up coughing phlegm for two hours. I coughed so hard I got laryngitis.
When the vising nurse finally came she told me I wasn't using the Voldyne correctly. She said I should just take deep breaths during TV commercials. This worked much better for me and made it easier to get the air under my diaphragm to cough up the phlegm.
This week has been moving along much better than last week. I finally made an appointment to see my Primary Care Doctor. He said I would probably be able to stop the pain medication by the end of next week. I am tapering off it because I know it can be addictive and I don't want to go that way.
I've been getting rides from friends. Louis Dagen drove me to the Doctor and has been very helpful, but I'm going to have to start driving my Maverick again. It's low to the ground and hard to get out of even without a bad back. The physical therapist showed me how to grab onto the door posts to pull myself up, so I hope that works.
I'm pricing new Focuses. I hope my insurance will cover replacement value and not the value of my old one. I'm still bummed about paying off that car early and then having it wiped out a month later.
I was glad I could stay a couple of days in the hospital. I found out that broken ribs are not covered by insurance for a hospital stay. That's probably why the young admissions clerk was so nervous. I'm not sure what my diagnosis was, possibly the low oxygen levels. I shall be writing a future blog on the corporatization of health care and the power of insurance companies. This is not a good trend.